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Rapid responses are not indexed in PubMed and they are not journal articles. \u003Cem\u003EThe BMJ\u003C\/em\u003E reserves the right to remove responses which are being wilfully misrepresented as published articles.\u003C\/div\u003E \u003C\/div\u003E\n \n \u003Cdiv class=\u0022view-filters\u0022\u003E\n \u003Cform action=\u0022\/\u0022 method=\u0022get\u0022 id=\u0022views-exposed-form-bmj-rapid-responses-bmj-rr-article\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cdiv\u003E\u003Cdiv class=\u0022views-exposed-form\u0022\u003E\n \u003Cdiv class=\u0022views-exposed-widgets clearfix\u0022\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-widget-sort-by\u0022\u003E\n \u003Cdiv class=\u0022form-type-select form-item-sort-by form-item form-group\u0022\u003E\n \u003Clabel for=\u0022edit-sort-by\u0022\u003ESort by \u003C\/label\u003E\n \u003Cselect class=\u0022form-control form-select\u0022 id=\u0022edit-sort-by\u0022 name=\u0022sort_by\u0022\u003E\u003Coption value=\u0022field_highwire_a_epubdate_value\u0022 selected=\u0022selected\u0022\u003EDate Published\u003C\/option\u003E\u003C\/select\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-widget-sort-order\u0022\u003E\n \u003Cdiv class=\u0022form-type-select form-item-sort-order form-item form-group\u0022\u003E\n \u003Clabel for=\u0022edit-sort-order\u0022\u003EOrder \u003C\/label\u003E\n \u003Cselect class=\u0022form-control form-select\u0022 id=\u0022edit-sort-order\u0022 name=\u0022sort_order\u0022\u003E\u003Coption value=\u0022ASC\u0022\u003EAscending\u003C\/option\u003E\u003Coption value=\u0022DESC\u0022 selected=\u0022selected\u0022\u003EDescending\u003C\/option\u003E\u003C\/select\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-widget-per-page\u0022\u003E\n \u003Cdiv class=\u0022form-type-select form-item-items-per-page form-item form-group\u0022\u003E\n \u003Clabel for=\u0022edit-items-per-page\u0022\u003EItems per page \u003C\/label\u003E\n \u003Cselect class=\u0022form-control form-select\u0022 id=\u0022edit-items-per-page\u0022 name=\u0022items_per_page\u0022\u003E\u003Coption value=\u00225\u0022\u003E5\u003C\/option\u003E\u003Coption value=\u002210\u0022 selected=\u0022selected\u0022\u003E10\u003C\/option\u003E\u003Coption value=\u002220\u0022\u003E20\u003C\/option\u003E\u003Coption value=\u002240\u0022\u003E40\u003C\/option\u003E\u003Coption value=\u002260\u0022\u003E60\u003C\/option\u003E\u003C\/select\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-exposed-widget views-submit-button\u0022\u003E\n \u003Cinput class=\u0022btn btn-info form-submit\u0022 type=\u0022submit\u0022 id=\u0022edit-submit-bmj-rapid-responses\u0022 name=\u0022\u0022 value=\u0022Apply\u0022 \/\u003E \u003C\/div\u003E\n \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003C\/form\u003E \u003C\/div\u003E\n \n \n \u003Cdiv class=\u0022view-content\u0022\u003E\n \u003Cdiv class=\u0022views-row views-row-1 views-row-odd views-row-first\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-33\u0022\u003E\u003Ch3\u003EResponse 4 to Allan S. Cunningham. Unlimited tolerance of vaccines?\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003ECunningham writes: \u201cIn my May 8 response to Joel Harrison I should have responded specifically to his discussion of our immune system and its seemingly unlimited capacity to respond to vaccines. Offit\u2019s articles are interesting, and they continue to be quoted in defense of our dense immunization schedule, but they are theoretical and do not prove that the benefits of the schedule outweigh the risks. Only trials of the type proposed by Fine, Aaby and Shann responses to Higgins.\u201d\u003C\/p\u003E\n\u003Cp\u003ENo one has claimed our immune system has an \u201cunlimited capacity\u201d to respond to vaccines. Offit explained its enormous capacity, on daily average we are exposed to up to 6,000 potentially dangerous microbes, so the 17 current vaccines, not given all at once, and increasing them by a few would not challenge our immune systems. (Harrison, 2019a) \u003C\/p\u003E\n\u003Cp\u003EFine (2007) writes: \u201cIt has long been known that vaccines can have effects other than reducing the risk of the disease against which they are targeted. Perhaps most obvious are the adverse reactions that, ALBEIT RARELY, can occur as a consequence of vaccination.\u201d\u003C\/p\u003E\n\u003Cp\u003EFine (2009) states: \u201cRoutine vaccination programmes have led to substantial declines in the incidence of most of the target diseases. In these circumstances, vaccine effects beyond those on the target diseases may become evident. . . Trials of such \u2018non-specific\u2019 effects are difficult if not impossible to organise.\u0022\u003C\/p\u003E\n\u003Cp\u003EAaby (2012) writes: \u201cRecent randomised trials have shown that live vaccines such as measles and BCG enhance general resistance, preventing other infections as well as the target infection.\u201d Aaby goes on to discuss how adding additional vaccines may affect the non-specific benefits of a particular vaccine and gender differences. \u003C\/p\u003E\n\u003Cp\u003ESaadatian-Elahi (2016) states: \u201cThe heterologous or non-specific effects (NSEs) of vaccines, at times defined as \u2018\u2018off-target effects\u201d suggest that they can affect the immune response to organisms other than their pathogen-specific intended purpose. These NSEs have been the subject of clinical, immunological and epidemiological studies and are increasingly recognized as an important biological process by a growing group of immunologists and epidemiologists. \u003C\/p\u003E\n\u003Cp\u003EStudies are ongoing, including various post-approval surveillance strategies (Harrison, 2019b). Cunningham ignores this. And he ignores the benefits\/cost ratio, how many kids and adults avoid suffering, hospitalizations, disabilities, and death because of the advent of vaccines vs the RARE serious adverse events. We don\u2019t live in a perfect world, would he sacrifice the many for the tragic few?\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cThere is at least one fatality caused by multiple vaccinations.\u003C\/p\u003E\n\u003Cp\u003EThe article says: \u201cA combination of vaccines that included smallpox and\u003Cbr \/\u003E\nanthrax might have contributed to the death of a young Army reservist . . . According to DoD\u0027s online Smallpox Vaccination Safety Summary, Lacy\u0027s case is the first case\u003Cbr \/\u003E\nin the current immunization program in which investigation indicated that the vaccine might\u003Cbr \/\u003E\nhave caused death. An important conclusion of both expert groups is that nothing was discovered that indicates our screening programs could have prevented the illness and ultimate death of Specialist Lacy, who had an underlying undiagnosed disorder.\u201d (Roos, 2003).\u003C\/p\u003E\n\u003Cp\u003ESo, \u201cmight\u201d is translated into certainty. For sake of argument, let\u2019s accept the combination of vaccines as having tragically caused her death. Cunningham continues to ignore the risks from the vaccine-preventable diseases. Smallpox is actually a vaccine with serious risks, previously, 1-2 deaths per million; but we now know about autoimmune diseases and wouldn\u2019t vaccinate them, though we might miss a few; however, if someone were to get hold of smallpox virus, unleash it on a civilian population that has not received smallpox vaccine for 50 years, there would be deaths in the millions. If one compares the risks, as tragic as her death was, if she had an underlying undiagnosed autoimmune disorder, then had she been exposed to any of the vaccine-preventable diseases, the outcome could also have been fatal. It would be extremely costly to screen every person in the US military for every possible immune disorder. Cunningham would sacrifice the vast majority for a possible minuscule number.\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cKawasaki disease first appeared in the 1960s and its frequency has marched upward right along with the expansion of the immunization schedule . . . This mysterious immune disorder has been associated with several vaccines in trials and case reports.\u201d The paper he cites (Uehara 2012) doesn\u2019t mention vaccines, though does state: \u201csome evidence indicates that children with illnesses similar to KD may have been identified since the late 19th century. Those cases may have been misdiagnosed as other childhood conditions.\u201d See also Lin (2017).\u003C\/p\u003E\n\u003Cp\u003EAbrams (2015) found: \u201cChildhood vaccinations\u2019 studied did not increase the risk of Kawasaki disease; conversely, vaccination was associated with a transient decrease in Kawasaki disease incidence.\u201d See also: Bonetto (2016); Esposito (2016); Wormsbecker (2019). \u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cIn spite of official pronouncements, vaccines have never been exonerated as potential causes of SIDS.\u201d\u003C\/p\u003E\n\u003Cp\u003EAccording to Wikipedia (Sudden infant death syndrome): \u201cA number of measures have been found to be effective in preventing SIDS including changing the sleeping position, breastfeeding, limiting soft bedding, immunizing the infant and using pacifiers.\u201d The Goldwater (2017) article cited by Cunningham includes in Box 2 under Post-natal risks: \u201cNo or late immunisation.\u201d M\u00fcller-Nordhorm (2015) concluded: \u201cIncreased DTP immunisation coverage is associated with decreased SIDS mortality,\u201d which updates the Ausiello (1997) study cited by Cunningham and the Talaat (2018).study cited by him doesn\u2019t mention SIDS. And the CDC (Vaccines and Sudden Infant Death) states: \u201cMultiple research studies and safety reviews have looked at possible links between vaccines and SIDS. The evidence accumulated over many years do not show any links between childhood immunization and SIDS.\u201d\u003C\/p\u003E\n\u003Cp\u003ECunningham overlooks one SIGNIFICANT FACT, the cases of SIDS, despite additional vaccines, has decreased significantly since 1990 (CDC Data and Statistics).\u003C\/p\u003E\n\u003Cp\u003ECunningham grasps at straws, ignores numerous vaccine safety studies, finds one possible death in someone with an undetected serious autoimmune disease, ignoring the innumerable lives protected by vaccines, accused vaccines of SIDS when as vaccines have increased, SIDS incidence has decreased, all in his continuous quest to undermine vaccines (see: Harrison, 2019a).\u003C\/p\u003E\n\u003Cp\u003EReferences:\u003C\/p\u003E\n\u003Cp\u003EAaby P, Whittle H, Benn CS (2012 Jun 14). Vaccine programmes must consider their effect on general resistance. BMJ; 344: e3769.\u003C\/p\u003E\n\u003Cp\u003EAbrams JY, Weintraub ES, Baggs JM et al. (2015). Childhood vaccines and Kawasaki disease, Vaccine Safety Datalink,1996-2006. Vaccine; 33: 382-387.\u003C\/p\u003E\n\u003Cp\u003EAusiello CM, Urbani F, La Sala A et al. (1997 Jun). Vaccine- and Antigen-Dependent Type 1 and Type 2 Cytokine Induction after Primary Vaccination of Infants with Whole-Cell or Acellular Pertussis Vaccines. Infection and Immunity; 65(6): 2168-2174.\u003C\/p\u003E\n\u003Cp\u003EBonetto C, Trotta F, Felicetti P et al. (2016). Vasculitis as an adverse event following immunization \u2013 Systematic literature review. Vaccine; 2016; 34: 6641-6651.\u003C\/p\u003E\n\u003Cp\u003ECDC (2018 Oct 16). Vaccines and Sudden Infant Death: Vaccines have not been shown to cause sudden infant death syndrome (SIDS). Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/vaccinesafety\/concerns\/sids.html\u0022\u003Ehttps:\/\/www.cdc.gov\/vaccinesafety\/concerns\/sids.html\u003C\/a\u003E [scroll down, click on Related Scientific Articles]\u003C\/p\u003E\n\u003Cp\u003ECDC (2019 Apr 10). Data and Statistics. Sudden Unexpected Infant Death and Sudden Infant Death Syndrome. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/sids\/data.htm\u0022\u003Ehttps:\/\/www.cdc.gov\/sids\/data.htm\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECunningham AS (2019 May 9). Unlimited tolerance of vaccines? BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-21\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-21\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EEsposito S, Bianchini S, Dellepiane RM, Principi N (2016). Vaccines and Kawasaki disease; 15(3): 417-424.\u003C\/p\u003E\n\u003Cp\u003EFine PEM, Smith PG (2007 Jan). Editorial: \u2018Non-specific effects of vaccines\u2019 \u2013 an important analytical insight, and call for a workshop. Tropical Medicine and International Health; 12(1): 1-4. Available at: \u003Ca href=\u0022https:\/\/onlinelibrary.wiley.com\/doi\/epdf\/10.1111\/j.1365-3156.2006.01794.x\u0022\u003Ehttps:\/\/onlinelibrary.wiley.com\/doi\/epdf\/10.1111\/j.1365-3156.2006.01794.x\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EFine PEM, Williams TN, Aaby P et al. (2009 Sep). Epidemiological studies of the \u2018non-specific effects\u2019 of vaccines: I \u2013 data collection in observational studies. Tropical Medicine and International Health; 14(9): 969-976. Available at: \u003C\/p\u003E\n\u003Cp\u003EGoldwater PN (2017 Aug). Infection: the neglected paradigm in SIDS research. 102(8): 767-772. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5537520\/pdf\/archdischild-2016-312327.pdf\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5537520\/pdf\/archdischild-20...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019a May 7). Response to Stone. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-14\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-14\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019b May 9). Response to Allan S. Cunningham. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-22\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-22\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHuang (2017 Jan). Vaccination and unexplained sudden death risk in Taiwanese infants. Pharmacoepidemiology and drug safety; 26(1): 17-25. Available at: \u003Ca href=\u0022https:\/\/onlinelibrary.wiley.com\/doi\/epdf\/10.1111\/j.1365-3156.2009.02301.x\u0022\u003Ehttps:\/\/onlinelibrary.wiley.com\/doi\/epdf\/10.1111\/j.1365-3156.2009.02301.x\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ELin (2017 Oct 31). The global epidemiology of Kawasaki disease: Review and future perspectives. Global Cardiology Science \u0026amp; Practice. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5856963\/\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5856963\/\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EM\u00fcller-Nordhorn J, Hettler-Chen CM, Keil T, Muckelbauer R (2015). Association between sudden infant death syndrome and diphtheria-tetanus-pertussis immunisation: an ecological study. BMC Pediatrics. Available at: \u003Ca href=\u0022https:\/\/bmcpediatr.biomedcentral.com\/track\/pdf\/10.1186\/s12887-015-0318-7\u0022\u003Ehttps:\/\/bmcpediatr.biomedcentral.com\/track\/pdf\/10.1186\/s12887-015-0318-7\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ERoos R (2003 Nov 19). Vaccines might have contributed to death of Army reservist. CIDRAP News. Available at: \u003Ca href=\u0022http:\/\/www.cidrap.umn.edu\/news-perspective\/2003\/11\/vaccines-might-have-contributed-death-army-reservist\u0022\u003Ehttp:\/\/www.cidrap.umn.edu\/news-perspective\/2003\/11\/vaccines-might-have-c...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ESaadatian-Elahi M, Aaby P, Shann F (2016 2016 Jul 25). Heterologous vaccine effects. Vaccine; 34: 3923-3930. Vaccine; 34(34): 3923-3930. \u003C\/p\u003E\n\u003Cp\u003ETalaat KR, Halsey NA, Cox AB et al. (2018 Mar). Rapid changes in serum cytokines and chemokines in response to inactivated influenza vaccination. Influenza and other respiratory viruses; 12(2): 202-210. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5820426\/pdf\/IRV-12-202.pdf\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5820426\/pdf\/IRV-12-202.pdf\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EUehara R, Belay ED (2012). Epidemiology of Kawasaki Disease in Asia, Europe, and the United States. Journal of Epidemiology; 22(2): 79-85.\u003C\/p\u003E\n\u003Cp\u003EWikipedia. Kawasaki disease. Available at: \u003Ca href=\u0022https:\/\/en.wikipedia.org\/wiki\/Kawasaki_disease\u0022\u003Ehttps:\/\/en.wikipedia.org\/wiki\/Kawasaki_disease\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EWikipedia. Sudden infant death syndrome. Available at: \u003Ca href=\u0022https:\/\/en.wikipedia.org\/wiki\/Sudden_infant_death_syndrome\u0022\u003Ehttps:\/\/en.wikipedia.org\/wiki\/Sudden_infant_death_syndrome\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EWormsbecker AE, Johnson C, Bourns L et al. (2019 Jan 15). Demonstration of background rates of three conditions of interest for vaccine safety surveillance. PLOS One; 14(1). Available at: \u003Ca href=\u0022https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0210833\u0022\u003Ehttps:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0210833\u003C\/a\u003E\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E20 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-2 views-row-even\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-31\u0022\u003E\u003Ch3\u003EResponse 4 to John Stone\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EStone (2019b) writes: \u201cI would point out my previous reply which was not about how I read Offit\u0027s article but how it was used to persuade people about the safety of administering multiple vaccines by Offit himself others, and with detailed documentation. When it is acknowledged, at least in some cases, that a single vaccine can carry a serious risk (smallpox, anthrax, yellow fever immediately come to mind) I am not sure that the calculation was ever anything more than a red-herring, but it was manifestly used by professionals when addressing the public to reassure them about the safety of multiple vaccine exposure - indeed Harrison still seems to think that it is reassuring - and I am simply pointing this out.\u201d\u003C\/p\u003E\n\u003Cp\u003EIn his previous reply, Stone (2019a) wrote: \u201cThere were several obvious things wrong with Offit\u2019s claim that 10,000 or 100,000 vaccines administered to an infant in one go might be safe.\u201d\u003C\/p\u003E\n\u003Cp\u003EIsn\u2019t the above about how Stone read Offit\u2019s article??? (see also: Harrison, 2016, 2019ab). Offit didn\u2019t claim 10,000 or 100,000 vaccines could be administered safely at one time. No one in their right mind would think so. It would be physically impossible. Currently there are only 17 vaccines for infants\/children, not all given at once. Makes no sense how one would go from 17 to 10,000 when no one could come up with even a small fraction of that number of microbes to develop vaccines for. \u003C\/p\u003E\n\u003Cp\u003EAs I wrote previously, I asked a random group of people what they would think if someone claimed that they would be giving 10,000 vaccines to infants\/children at one time. Every one just laughed (Harrison, 2019b). It doesn\u2019t matter if others mention this without the context supplied by Offit. It\u2019s not a red herring, it is explaining just how robust our immune systems are. And, yes, I do think it should be reassuring to reasonable people. But even if it weren\u2019t reassuring to some people, it is a legitimate attempt. If I were to tell someone I can construct a steel reinforced concrete wall that will withstand heavy wrecking balls so they needn\u2019t worry about kids, even dozens, throwing rocks at it, how does this differ? \u003C\/p\u003E\n\u003Cp\u003EAnd as I\u2019ve also explained umpteen times, on average per day, we are exposed to up to 6,000 potentially dangerous microbes at their full strength as opposed to, currently, 17 killed or attenuated ones. This is reality.\u003C\/p\u003E\n\u003Cp\u003EStone brings up smallpox, anthrax, and yellow fever. \u003C\/p\u003E\n\u003Cp\u003ESmallpox was eradicated from the Western Hemisphere by 1971 (CDC, 2016; College of Physicians, 2018). \u201cBecause of vaccination programs and quarantine regulations, the risk of importation of smallpox into the United States was reduced by the 1960s. As a result, routine vaccinia vaccination was discontinued in 1971 . . . Since January 1982, smallpox vaccination has not been required for international travelers\u201d (CDC, 1991)\u003C\/p\u003E\n\u003Cp\u003EHowever, we keep a supply in case a group of terrorists obtained smallpox, releasing in several airports with connecting flights. And previously 1-2 deaths per million were caused by the vaccine; but nowadays we know about autoimmune diseases, so they would not receive it. However, with an unvaccinated population, we could see millions of deaths within a few weeks, plus 10s of millions going through hell. And we are working on a better smallpox vaccine. \u003C\/p\u003E\n\u003Cp\u003EAnthrax: \u201cThe vaccine is recommended for adults 18 through 65 years of age who are at risk of exposure to anthrax bacteria . . . Anthrax vaccine is also recommended for unvaccinated people of all ages who have been exposed to anthrax . . . the first vaccine dose as soon after exposure as possible.\u201d (CDC, 2018) For a period of time we stopped using it for military because of alleged serious adverse reactions; but after careful review program was restarted (Wikipedia. Anthrax vaccine).\u003C\/p\u003E\n\u003Cp\u003EYellow Fever: The last outbreak occurred in New Orleans 1905 (CDCb, 2019). \u201cVaccine is recommended for people aged 9 months or older and who are traveling to or living in areas at risk for yellow fever virus in Africa and South America.\u201d (CDC, 2019a; see also Wikipedia. Yellow Fever)\u003C\/p\u003E\n\u003Cp\u003ESo Stone mentions three vaccines that are neither obligatory nor even recommended, except the yellow fever vaccine for those traveling and anthrax for military going to areas of world where prevalent. However, all three are serious diseases, causing immense suffering, with high risks of death. Though we don\u2019t currently vaccinate the public for them, if a real threat occurred, the risks of a few tragically suffering adverse reactions would be far outweighed by the much higher number of deaths, even if one were to discount the suffering for those who survive.\u003C\/p\u003E\n\u003Cp\u003EStone ignores what I have written about the immune system and Paul Offit, both in the current RR exchange and in other articles he is aware of (e.g., Harrison, 2016) and claims that his \u201cprevious reply was not about how he read Offit\u0027s article but how it was used to persuade people about the safety of administering multiple vaccines by Offit himself\u201d which is not true. And as I\u2019ve pointed out earlier, Stone focuses on one thing at a time, ignoring how I have refuted a number of claims made by him in this exchange. And finally, he mentions three vaccines, none mandatory, none even recommended except yellow fever for travelers to certain areas. And he seems totally oblivious to any of this. So, in my opinion, Stone is a typical example of many antivaccinationists, who base their position on a lack of understanding of the sciences underlying vaccines, a lack of critical thinking\/logic, and lack of common sense, cherry-picking\/confirmation bias based on a fantasy world with little to no reality testing. As more people listen to antivaccinationists, the risks to children from vaccine-preventable diseases increases. \u003C\/p\u003E\n\u003Cp\u003EReferences:\u003C\/p\u003E\n\u003Cp\u003ECDC (1991 Dec 13). Vaccinia (Smallpox) Vaccine Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR; 40(RR14): 1-10. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/00042032.htm\u0022\u003Ehttps:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/00042032.htm\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (2016 Aug 30). History of Smallpox. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/smallpox\/history\/history.html\u0022\u003Ehttps:\/\/www.cdc.gov\/smallpox\/history\/history.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (2018 Mar 21). Anthrax Vaccine - What You Need to Know. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/vaccines\/hcp\/vis\/vis-statements\/anthrax.html\u0022\u003Ehttps:\/\/www.cdc.gov\/vaccines\/hcp\/vis\/vis-statements\/anthrax.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (2019a Jan 15). Yellow Fever Vaccine. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/yellowfever\/vaccine\/index.html\u0022\u003Ehttps:\/\/www.cdc.gov\/yellowfever\/vaccine\/index.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (accessed 2019b May 16). Yellow Fever History Timeline. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/travel-training\/local\/HistoryEpidemiologyandVaccination\/HistoryTimelineTranscript.pdf\u0022\u003Ehttps:\/\/www.cdc.gov\/travel-training\/local\/HistoryEpidemiologyandVaccinat...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2016 Mar 18). Ignoring Context and a Lack of Common Sense: Antivaccinationists Absurdly Misusing Dr. Paul Offit\u2019s \u201ceach infant would have the theoretical capacity to respond to about 10,000 vaccines at any one time\u201d. Vaccinate Your Family. Available at: \u003Ca href=\u0022https:\/\/64gbq3vj11cj33l2zkxvv10k-wpengine.netdna-ssl.com\/wp-content\/uploads\/2019\/04\/Ignoring_Context_and_a_Lack_of_Common_Sense_-_10000_Vaccinations_at_One_Time.pdf\u0022\u003Ehttps:\/\/64gbq3vj11cj33l2zkxvv10k-wpengine.netdna-ssl.com\/wp-content\/uplo...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019a May 7). Re: US county bars unvaccinated children from public spaces amid measles emergency. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-14\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-14\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019b May 10). Response to John Stone\u2019s \u201cOffit\u2019s calculation was misleading\u201d. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-23\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-23\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EStone J (2019 May 8). Reply to Joel Harrison - Offit\u0027s calculation was misleading. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-11\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-11\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EStone J (2019 May 15). Re: US county bars unvaccinated children from public spaces amid measles emergency. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-27\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-27\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EThe College of Physicians of Philadelphia (2018 Jan 17). Government Regulations. History of Vaccines. Available at: \u003Ca href=\u0022https:\/\/www.historyofvaccines.org\/index.php\/content\/articles\/government-regulation\u0022\u003Ehttps:\/\/www.historyofvaccines.org\/index.php\/content\/articles\/government-...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EWikipedia. Anthrax vaccine. Available at: \u003Ca href=\u0022https:\/\/en.wikipedia.org\/wiki\/Anthrax_vaccines#American_anthrax_vaccines\u0022\u003Ehttps:\/\/en.wikipedia.org\/wiki\/Anthrax_vaccines#American_anthrax_vaccines\u003C\/a\u003E\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E18 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-3 views-row-odd\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-30\u0022\u003E\u003Ch3\u003EResponse 3 to Dr Anand: Callous Disregard For The Vulnerable Innocents\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EAnand writes: \u201cI am immensely grateful to Dr Harrison for continuing to demonstrate his philosophy of treating fellow human beings. He believes in compulsion, in bullying. I believe in discussing, converting. Here in the UK, we abolished compulsory vaccination against smallpox in 1948. Smallpox disappeared from the world in 1978, if my memory serves (Anand, 2019).\u201d\u003C\/p\u003E\n\u003Cp\u003EAs I previously wrote, which he seems to ignore, we live in communities, thus we have both rights AND responsibilities (Harrison, 2019ab). Prior to the 21st Century, vaccine rates remained quite high; but as individual and organized groups of antivaccinationists proliferated, clusters of low vaccination rates grew, resulting in outbreaks of measles, involving suffering for 7 - 10 days, hospitalizations, cases in intensive care, potential disabilities, and deaths. Numerous studies have found that, despite attempts to explain the safety profiles of vaccines, the risks from vaccine-preventable diseases, and the effectiveness of vaccines, many who have chosen not to vaccinate their children ignore this or actively believe that it is all lies, part of a vast conspiracy to further the profits of the pharmaceutical industry (e.g., Benegal, 218; DeStefano, 2019; Fisher, 2019; Hornsey, 2018; Kennedy, 2019; Linus, 2019; Motta, 2018ab; Moyer, 2018; Rodriguez, 2018) I have far more articles. In fact, as an example, despite both appeals from public health authorities and chief rabbis, some groups of Orthodox Jews remain unvaccinated (e.g., Boodman, 2019; Kadish, 2019). So, as I\u2019ve written numerous times, how do we protect those who can\u2019t be vaccinated or, for whatever reason, the vaccines didn\u2019t take?\u003C\/p\u003E\n\u003Cp\u003EThough in the early part of the 20th Century, compulsory vaccinations for smallpox were carried out (College of Physicians, 2019), compulsory vaccination has not been implemented in the US during my life-time (CDC, 1991, 2016). And if one looks at the high infectious rate and deaths from smallpox at the beginning of the 20th Century, its highly contagious nature, together with the urban poor living conditions in dense crowded housing with little sanitation, compulsory vaccinations were a valid public health measure. Compulsory vaccinations ended in US as well as UK; but we kept stockpiles of vaccines ready if smallpox shouId arise in our respective nations. I remember traveling to Europe in 1968, smallpox vaccination was required, despite having been vaccinated as an infant; but no longer. However, given, for instance, the current outbreak of measles, unvaccinated kids have been banned from schools, playgrounds, public areas, but no compulsory vaccinations. \u003C\/p\u003E\n\u003Cp\u003EIn both the US and UK we have laws against drinking and driving. Someone\u2019s right to drink and drive doesn\u2019t trump others rights to avoid accidents caused by drunk drivers. Police can pull a driver over, request he\/she takes a breathalyzer test. If they refuse, they are taken to local hospital for a blood test. We have laws against loud music late at night. We have laws against owning unlicensed firearms, though the UK superior to US in this regard, with, despite a high immigrant population, a far lower homicide rate. And both nations have quarantine laws. Yet, both nations also have educational programs to discourage people from drinking and driving, from owning unlicensed firearms, etc. Perhaps, Anand believes all the above wrong, i.e., society has no right to impose any restrictions on individual behavior. \u003C\/p\u003E\n\u003Cp\u003EAt some point when educational programs fail, how would Anand suggest we protect the vulnerable innocents? I am all for education and persuasion; but, when these fail, I apparently care much more about the vulnerable innocents than Anand. So, if he chooses, because I care about the vulnerable innocents, to accuse me of supporting compulsion and bullying, absurd, I accuse him of a callous disregard for the vulnerable innocents in our respective societies. \u003C\/p\u003E\n\u003Cp\u003EIn the current exchanges with him, I have shown him wrong on a number of claims he made, and he has not responded (Harrison, 2019ab), nor offered a response for how to protect the vulnerable innocents among us except for \u201cdiscussing, converting,\u201d apparently unaware or ignoring just how much effort has gone into this, failed and continues! And I support continued efforts to use education and persuasion; but, even if they eventually succeed, in the meantime, the vulnerable innocents remain ! \u003C\/p\u003E\n\u003Cp\u003EReferences:\u003C\/p\u003E\n\u003Cp\u003EAnand JK (2019). Re: US county bars unvaccinated children from public spaces amid measles emergency. Response to Dr Joel Harrison. BMJ Rapid Response. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-28\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-28\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EBenegal S (2018). Overconfidence and the discounting of expertise: A commentary. Social Science \u0026 Medicine; 213: 95-97. \u003C\/p\u003E\n\u003Cp\u003EBoodman (2019 May 10). What a Grand Rabbi\u02bcs request might teach each us about combating vaccine hesitancy. STAT. Available at: \u003Ca href=\u0022https:\/\/www.statnews.com\/2019\/05\/10\/measles-rabbi-combating-vaccine-hesitancy\/\u0022\u003Ehttps:\/\/www.statnews.com\/2019\/05\/10\/measles-rabbi-combating-vaccine-hesi...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (1991 Dec 13). Vaccinia (Smallpox) Vaccine Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR; 40(RR14): 1-10. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/00042032.htm\u0022\u003Ehttps:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/00042032.htm\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (2016 Aug 30). History of Smallpox. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/smallpox\/history\/history.html\u0022\u003Ehttps:\/\/www.cdc.gov\/smallpox\/history\/history.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECollege of Physicians of Philadelphia (2018 Jan 17). Government Regulations. History of Vaccines. US Supreme Court Addresses Vaccination 2\/20\/1905. Available at: \u003Ca href=\u0022https:\/\/www.historyofvaccines.org\/timeline#EVT_107\u0022\u003Ehttps:\/\/www.historyofvaccines.org\/timeline#EVT_107\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EDeStefano F, Bodenstab HM, Offit PA (2019). Principal Controversies in Vaccine Safety in the United States. Clinical Infectious Diseases. Available at: \u003Ca href=\u0022https:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciz135\/5316263\u0022\u003Ehttps:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciz135\/5316263\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EFisher F (2019 Jan 28). The Hidden Reason Behind Low Vaccination Rates In The U.S. Forbes. Available at: \u003Ca href=\u0022https:\/\/www.forbes.com\/sites\/nicolefisher\/2019\/01\/28\/the-hidden-reason-behind-low-vaccination-rates-in-the-u-s\/#4fbfe40a1527\u0022\u003Ehttps:\/\/www.forbes.com\/sites\/nicolefisher\/2019\/01\/28\/the-hidden-reason-b...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019a May 8). Response to Dr Anand. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-17\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-17\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019b May 15). Response 2 to Dr Anand. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-25\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-25\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHornsey MJ, Harris EA, Fielding KS (2018). The Psychological Roots of Anti-Vaccination Attitudes: A 24-Nation Investigation. Health Psychology; 37(4): 307-315. Available at: \u003Ca href=\u0022https:\/\/www.apa.org\/pubs\/journals\/releases\/hea-hea0000586.pdf\u0022\u003Ehttps:\/\/www.apa.org\/pubs\/journals\/releases\/hea-hea0000586.pdf\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EKadish A (2019 Apr 22). When did measles become Jewish?: Vaccinating children is a moral, ethical and religious requirement. New York Daily News. Available at: \u003Ca href=\u0022https:\/\/www.nydailynews.com\/opinion\/ny-oped-when-did-measles-become-jewish-20190422-bjtqv2cdxrhx5i7gii3miuh6km-story.html\u0022\u003Ehttps:\/\/www.nydailynews.com\/opinion\/ny-oped-when-did-measles-become-jewi...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EKennedy J (2019 Feb 25). Populist politics and vaccine hesitancy in Western Europe: an analysis of national-level data. European Journal of Public Health. Available at: \u003Ca href=\u0022https:\/\/academic.oup.com\/eurpub\/advance-article\/doi\/10.1093\/eurpub\/ckz004\/5364298\u0022\u003Ehttps:\/\/academic.oup.com\/eurpub\/advance-article\/doi\/10.1093\/eurpub\/ckz00...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ELinas BS (2019 Feb 23). Anti-Vaxxers Are Here to Stay. Scientific American Blog Network. Available at: \u003Ca href=\u0022https:\/\/blogs.scientificamerican.com\/observations\/anti-vaxxers-are-here-to-stay\/?redirect=1\u0022\u003Ehttps:\/\/blogs.scientificamerican.com\/observations\/anti-vaxxers-are-here-...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EMotta M, Sylvester S, Callaghan T (2018a Jul 12). Why vaccine opponents think they know more than medical experts. The Conversation. Available at: \u003Ca href=\u0022https:\/\/theconversation.com\/why-vaccine-opponents-think-they-know-more-than-medical-experts-99278\u0022\u003Ehttps:\/\/theconversation.com\/why-vaccine-opponents-think-they-know-more-t...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EMotta M, Callaghan T, Sylvester S (2018b Aug). Knowing less but presuming more: Dunning-Kruger effects and the endorsement of anti-vaccine policy attitudes. Social Science \u0026 Medicine; 211: 274-281. Available at: \u003Ca href=\u0022https:\/\/www.sciencedirect.com\/science\/article\/pii\/S027795361830340X?via%3Dihub\u0022\u003Ehttps:\/\/www.sciencedirect.com\/science\/article\/pii\/S027795361830340X?via%...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EMoyer MW (2018 Aug 4). Anti-Vaccine Activists Have Taken Vaccine Science Hostage. The New York Times. Available at: \u003Ca href=\u0022https:\/\/www.nytimes.com\/2018\/08\/04\/opinion\/sunday\/anti-vaccine-activists-have-taken-vaccine-science-hostage.html\u0022\u003Ehttps:\/\/www.nytimes.com\/2018\/08\/04\/opinion\/sunday\/anti-vaccine-activists...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ERodriguez R (2018 May 4). The \u0027Attitude Roots\u0027 Underlying Antivaccination Beliefs. The Infectious Disease Advisor. Available at: \u003Ca href=\u0022https:\/\/www.infectiousdiseaseadvisor.com\/home\/topics\/prevention\/the-attitude-roots-underlying-antivaccination-beliefs\/\u0022\u003Ehttps:\/\/www.infectiousdiseaseadvisor.com\/home\/topics\/prevention\/the-atti...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ESmith TC (2017 Summer). Vaccine Rejection and Hesitancy: A Review and Call to Action. Open Forum Infectious Diseases; 4(3). Available at: \u003Ca href=\u0022https:\/\/academic.oup.com\/ofid\/article\/4\/3\/ofx146\/3978712\u0022\u003Ehttps:\/\/academic.oup.com\/ofid\/article\/4\/3\/ofx146\/3978712\u003C\/a\u003E\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E18 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-4 views-row-even\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-29\u0022\u003E\u003Ch3\u003ERe: US county bars unvaccinated children from public spaces amid measles emergency\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EResponse 2 to Allan S. Cunningham\u003C\/p\u003E\n\u003Cp\u003ENOTE. SUBMITTED EARLIER. DIDN\u2019T CHECK IF IT WENT THROUGH. RESPONDS TO FIRST PARAGRAPH OF CUNNINGHAM (2019) \u0026amp; (2017)\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cHas Dr. Harrison read Paul Fine and Peter Smith\u2019s editorial about \u201cNon-specific vaccine effects\u201d? (Tropical Medicine and International Health 2007;12:1).\u201d\u003C\/p\u003E\n\u003Cp\u003EFirst, the vaccines mandated for children in US are for diseases almost all children experienced prior to advent of vaccines, not the killed or attenuated; but full strength. We now know that measles, for instance, suppressed the immune system for months, possibly longer, so kids that developed disabilities, even died, after measles could quite well have been its victims. The Fine editorial discusses the controversial finding of excess mortality in children who received a high titre measles vaccine in Africa. For sake of argument let\u2019s accept the finding. Tragic; but measles vaccine is one that Cunningham definitely supports. In the history of medicine, many early interventions failed and even sometimes caused more harm than good, but we didn\u2019t give up on them; but learned from them. Dredging up early vaccine failures seems more an attempt to caste a shadow on vaccines in general. And Aaby\u2019s article starts with \u201cRecent randomised trials have shown that live vaccines such as measles and BCG enhance general resistance, preventing other infections as well as the target infection.\u201d So, his article discusses that randomized trials have look at and continue to look at non-specific effects.\u003C\/p\u003E\n\u003Cp\u003EOther findings include early vaccinations reducing risk of childhood leukemia and rotavirus vaccine reducing risk of Type 1 diabetes. The most plausible explanation for Type 1 diabetes is molecular mimicry. Some people have a genetic inheritance where the insulin producing cells have membranes with short sections (antigens) that are similar to the membranes of the rotavirus. So, once our immune system reacts to the rotavirus, they proceed to attack our insulin producing cells, a case of mistaken identity. I admit, as opposed to antivaccinationists, these findings are preliminary; but compelling.\u003C\/p\u003E\n\u003Cp\u003EAnd another article with Aaby as a co-author states: \u201cFor example, Bacille Calmette-Guerin (BCG), smallpox, measles, oral polio and yellow fever vaccines may reduce disease and\/or mortality from infections other than tuberculosis, smallpox, measles, polio, yellow fever, respectively, and some vaccines have even shown promise when repurposed against certain cancers and\/or autoimmune disorders. These heterologous or non-specific effects (NSEs) of vaccines, occasionally also termed \u2018\u2019off-target effects\u201d, suggest that some vaccines can provide greater protection than their pathogen-specific intended purpose.\u201d\u003C\/p\u003E\n\u003Cp\u003EThere is some controversy about the timing of the DTP vaccines in Third World nations and ongoing research is looking at it. However, there is one virus, Dengue, that involves what has been termed \u201cantibody dependent enhancement.\u201d Basically, if first exposed to one of the five serotypes, this alters some proteins in our bodies such that they facilitate entrance of other serotypes, resulting in a deadly condition, dengue hemorrhagic fever. Thus, until a vaccine can be developed that protects against all five serotypes, any vaccine for fewer serotypes actually puts people at grave risk. Cunningham extends it to flu vaccines as well. It would take a separate paper to address his claims regarding the flu vaccine. Yep, there exists some studies that find an increased risk for some; but far more studies contradict these and despite Cunningham\u2019s claim that the dangers of the flu are exaggerated, they are actually worse. If someone dies, for instance, of pneumonia or heart disease, hospitals don\u2019t always conduct serology to determine if they recently suffered from flu. Flu damages lung epithelial cells allowing for opportunistic bacterial pneumonias and the stress of flu can further damage an already weakened heart. And, despite Cunningham\u2019s claims as to effectiveness of the flu vaccine, I would get it if only 10% effective because, though this means that 90% who get the vaccine will still get the flu, it also means a reduced level of severity, reduced risk for hospitalization and death. Since the overall research, despite a few studies, support flu vaccines, I get mine every year and recommend it to friends.\u003C\/p\u003E\n\u003Cp\u003EThough Cunningham seems to be unaware, research on both Non-Specific Vaccine Effects\/Heterogenous Vaccine Effects and Antibody-Dependent Enhancement have been and continue to be carried out, going back decades before the 21st Century (CDC, PubMed [Note not all PubMed articles found are relevant; but most are.]\u003C\/p\u003E\n\u003Cp\u003EFinally, Cunningham writes: \u201cA case can be made for mandating diphtheria, pertussis, polio and measles vaccines for US children. These vaccines should be free, and we should be willing to delay initiating vaccination until 4-6 months of age. Other vaccines should be voluntary until their long-term safety and cost-effectiveness have been established by high quality and unbiased research.\u201d\u003C\/p\u003E\n\u003Cp\u003ESo, he wouldn\u2019t recommend HiB Type B, despite: \u201cBefore Hib vaccination, about 20,000 children younger than five developed severe Hib disease in the United States each year, and about 1,000 died\u201d and many suffered lifetime disabilities. Or rotavirus, despite: \u201cPrior to vaccine introduction, almost all U.S. children were infected with rotavirus before their 5th birthday. Each year, among U.S. children younger than 5 years of age, rotavirus led to more than 400,000 doctor visits, more than 200,000 emergency room visits, 55,000 to 70,000 hospitalizations, and 20 to 60 deaths.\u201d\u003C\/p\u003E\n\u003Cp\u003EAnd I\u2019ve refuted over and over his claim of a lack of long-term safety unbiased research and the timing of vaccinations. He is cherry-picking studies that confirm his bias, ignoring that even if well-done, the risk of uncontrolled variables influencing results exist, which is why I look at as many studies as I can find on a continuous basis over the past 40 years, which he interprets as a lack of humility on my part. So, is Cunningham an antivaccinationist? He does support some vaccines; albeit his RRs question overall vaccine safety and efficacy studies as biased, etc, together with his BIASED cherry-picking, I\u2019ll leave it up to the reader to decide.\u003C\/p\u003E\n\u003Cp\u003EReferences:\u003C\/p\u003E\n\u003Cp\u003ECDC (accessed 2019 May 10). Search: Antibody Dependent Enhancement. Available at: \u003Ca href=\u0022https:\/\/search.cdc.gov\/search\/?query=antibody+dependent+enhancement\u0026amp;sitelimit=\u0026amp;utf8=\u0022\u003Ehttps:\/\/search.cdc.gov\/search\/?query=antibody+dependent+enhancement\u0026amp;site...\u003C\/a\u003E\u2713\u0026amp;affiliate=cdc-main\u003C\/p\u003E\n\u003Cp\u003ECDC (2018 Feb 13). Haemophilus influenzae Disease (Including Hib). COMPLICATIONS. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/hi-disease\/about\/diagnosis-treatment.html\u0022\u003Ehttps:\/\/www.cdc.gov\/hi-disease\/about\/diagnosis-treatment.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (accessed 2019 May 10). Search: Non-Specific Vaccine Effects. Available at: \u003Ca href=\u0022https:\/\/search.cdc.gov\/search\/?query=Non-Specific+Vaccine+Effects\u0026amp;sitelimit=\u0026amp;utf8=\u0022\u003Ehttps:\/\/search.cdc.gov\/search\/?query=Non-Specific+Vaccine+Effects\u0026amp;siteli...\u003C\/a\u003E\u2713\u0026amp;affiliate=cdc-main\u003C\/p\u003E\n\u003Cp\u003ECDC (2018 Apr 23). Rotavirus in the U.S. BURDEN. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/rotavirus\/surveillance.html\u0022\u003Ehttps:\/\/www.cdc.gov\/rotavirus\/surveillance.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECollege of Physicians of Philadelphia (2018 Jan). Haemophilus influenzae type b (Hib). Available at: \u003Ca href=\u0022https:\/\/www.historyofvaccines.org\/content\/articles\/haemophilus-influenzae-type-b-hib\u0022\u003Ehttps:\/\/www.historyofvaccines.org\/content\/articles\/haemophilus-influenza...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECunningham AS (2017 Sep 22). Vaccine authorities don\u0027t want to know about adverse effects. II. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/358\/bmj.j4100\/rr-6\u0022\u003Ehttps:\/\/www.bmj.com\/content\/358\/bmj.j4100\/rr-6\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECunningham AS (2017 Dec 21). Dengue vaccine and influenza vaccine are both subject to increased illness risk via \u0022antibody-dependent enhancement\u201d. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/359\/bmj.j5759\/rr\u0022\u003Ehttps:\/\/www.bmj.com\/content\/359\/bmj.j5759\/rr\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECunningham AS (2019 Mar 28). Unlimited tolerance of vaccines? Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-21\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-21\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EMorra ME, Kien ND, Elmaraezy A et al. (2017 Nov 22). Early vaccination protects against childhood leukemia: A systematic review and meta-analysis. Scientific Reports; 7: 15986. Available at: \u003Ca href=\u0022https:\/\/www.nature.com\/articles\/s41598-017-16067-0\u0022\u003Ehttps:\/\/www.nature.com\/articles\/s41598-017-16067-0\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EPubMed (accessed 2019 May 10). Search: Antibody Dependent Enhancement [Found 2581 going back to 1962] Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=antibody+dependent+enhancement\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=antibody+dependent+enhancement\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EPubMed (accessed 2019 May 10). Search: Non-Specific Vaccine Effects. [Found 514 going back to 1975] Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=non-specific+vaccine+effects\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=non-specific+vaccine+effects\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EPerrett KP, Jachno K, Nolan T, Harrison LC (2019 Jan 22). Association of Rotavirus Vaccination With the Incidence of Type 1 Diabetes in Children. JAMA Pediatrics;173(3):280-282.\u003C\/p\u003E\n\u003Cp\u003ERojas M, Restrepo-Jim\u00e9nez P, Monsalve DM et al. (2018). Molecular mimicry and autoimmunity. Journal Of Autoimmunity; 95: 100-123. Available at: \u003Ca href=\u0022https:\/\/reader.elsevier.com\/reader\/sd\/pii\/S0896841118305365?token=BCCBFA832F0D6206120F590B676D26B93ABC39E088236049F8A5AFB2FACEC519BA422586A6FA3EC4C0DE62DD2F87A7F5\u0022\u003Ehttps:\/\/reader.elsevier.com\/reader\/sd\/pii\/S0896841118305365?token=BCCBFA...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ESaadatian-Elahi M, Aaby P, Shann F et al. (2016). Heterologous vaccine effects. Vaccine; 34: 3923-3930. Available at: \u003Ca href=\u0022https:\/\/www.fondation-merieux.org\/wp-content\/uploads\/2017\/02\/off-target-effects-of-vaccination-2015-report.pdf\u0022\u003Ehttps:\/\/www.fondation-merieux.org\/wp-content\/uploads\/2017\/02\/off-target-...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ETaylor A, Foo SS, Bruzon R et al. (2015 Nov). Fc receptors in antibody-dependent enhancement of viral infections. Immunologic Reviews; 268: 304-364. \u003C\/p\u003E\n\u003Cp\u003EWikipedia. Antibody-dependent enhancement. Available at: \u003Ca href=\u0022https:\/\/en.wikipedia.org\/wiki\/Antibody-dependent_enhancement\u0022\u003Ehttps:\/\/en.wikipedia.org\/wiki\/Antibody-dependent_enhancement\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EWikipedia. Molecular Mimicry. Available at: \u003Ca href=\u0022https:\/\/en.wikipedia.org\/wiki\/Molecular_mimicry\u0022\u003Ehttps:\/\/en.wikipedia.org\/wiki\/Molecular_mimicry\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EWikipedia. Non-specific effect of vaccines. Available at: \u003Ca href=\u0022https:\/\/en.wikipedia.org\/wiki\/Non-specific_effect_of_vaccines\u0022\u003Ehttps:\/\/en.wikipedia.org\/wiki\/Non-specific_effect_of_vaccines\u003C\/a\u003E\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E16 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-5 views-row-odd\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-28\u0022\u003E\u003Ch3\u003ERe: US county bars unvaccinated children from public spaces amid measles emergency. Response to Dr Joel Harrison\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EI am immensely grateful to Dr Harrison for continuing to demonstrate his philosophy of treating fellow human beings.\u003Cbr \/\u003E\nHe believes in compulsion, in bullying.\u003Cbr \/\u003E\nI believe in discussing, converting. \u003C\/p\u003E\n\u003Cp\u003EHere in the UK, we abolished compulsory vaccination against smallpox in 1948. Smallpox disappeared from the world in 1978, if my memory serves. \u003C\/p\u003E\n\u003Cp\u003EOf course Dr Harrison and others of his ilk cannot be and should not be forced to think like me, to talk like me. \u003C\/p\u003E\n\u003Cp\u003EMy phraseology has been, I trust, courteous. \u003C\/p\u003E\n\u003Cp\u003EWith belief in my fallibility, and in humility, I remain, Dr Harrison,\u003C\/p\u003E\n\u003Cp\u003ESincerely yours\u003Cbr \/\u003E\nJK Anand\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E15 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n JK Anand \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Retired doctor \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n Free spirit \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n Peterborough, England \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-6 views-row-even\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-26\u0022\u003E\u003Ch3\u003ERe: US county bars unvaccinated children from public spaces amid measles emergency\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EResponse 3 to Allan S. Cunningham\u003C\/p\u003E\n\u003Cp\u003EAs I wrote in Response 2, it would take a paper with hundreds of references to show that the weight of evidence supports both the seriousness of flu and the value of the flu vaccine. However, as one more example of cherry-picking confirmation bias, he writes: \u201cRight now I am waiting for the BMJ to publicize the latest piece of bad news about influenza vaccines: an overall doubling of miscarriage risk among women who get flu shots early in pregnancy, and an 8-fold increase in risk after getting the second of two pH1N1-containing vaccines in consecutive seasons. (Donahue, Vaccine 2017;35:5314) The more we hear about them the more we realize that, like the fabled emperor, the flu vaccines have no clothes.\u201d\u003C\/p\u003E\n\u003Cp\u003EThe authors of the study admit to several weaknesses, among them: \u201cit is possible that women with certain comorbidities or other risk factors for SAB were preferentially vaccinated. . . vaccination status may have been misclassified if women received a vaccine that was both outside of their health care system and not reported to their provider . . . It is important to note that this study does not and cannot confirm a causal association.\u201d(Donahue, 2017)\u003C\/p\u003E\n\u003Cp\u003EIn a subsequent exchange of letters, the authors, while defending their methodology, write: \u201cInfluenza infection poses a serious risk to pregnant women and their children, and we support current ACIP recommendations for vaccination during pregnancy. We understand these study results may be concerning for pregnant women and expect a follow-up study will be completed by early 2019. Until then, patients should be educated regarding vaccine recommendations, findings and uncertainties of this study, and the overall strong safety profile of influenza vaccination during pregnancy.\u201d (Donahue, 2018)\u003C\/p\u003E\n\u003Cp\u003EIn a review of flu vaccine and pregnancy, Giles et al. include several similar studies that found NO risk and their overall conclusion was: \u201cthere is no evidence of an increased risk of adverse pregnancy outcomes following influenza vaccination in pregnancy. Despite this reassuring finding, there remain some important areas where more data from ongoing surveillance and formal research projects for pregnancy-related safety of vaccination would be beneficial.\u201d (Giles, 2019)\u003C\/p\u003E\n\u003Cp\u003EAnd Dr. Paul Offit writes: \u201cThe CDC\u02bcs observation was inconsistent. Researchers had studied two influenza-vaccine seasons: 2010-2011 and 2011-2012. The problem of first trimester spontaneous abortions occurred during the first season but not the second. . . Six previous studies had failed to find any evidence that an influenza vaccine given during the first trimester had increased the risk of spontaneous abortions. In other words, the CDC study was an outlier.\u201d (Offit, 2017)\u003C\/p\u003E\n\u003Cp\u003ENotice that the Donahue study authors included Frank DeStefano, who has authored numerous articles supporting vaccines. So, it shows that even the staunchest supporters of vaccines do so in an objective manner, not biased as Cunningham would like to believe ! ! !\u003C\/p\u003E\n\u003Cp\u003EAnd the Donahue follow-up study has now been completed and guess what? No association was found. Their conclusion: \u201cNo significant association between influenza vaccine receipt and SAB, regardless of prior season vaccination status. Odds ratios were less than or close to 1.0 in all risk windows.\u201d (Donahue, 2019) So, Cunningham seems to have leapt at the chance to attack a vaccine based on one study, a study that itself explicitly stated it could not determine a causal association and listed a number of caveats. Cunningham did not discuss studies that found no association. And Cunningham didn\u2019t wait until the second Donahue study was carried out.\u003C\/p\u003E\n\u003Cp\u003ESo much for Cunningham\u2019s: \u201cThe more we hear about them the more we realize that, like the fabled emperor, the flu vaccines have no clothes.\u201d Cunningham\u2019s antivaccine bias is quite clear. For him, the estimated 36,400 - 61,200 deaths attributed to flu, the estimated 531,000 - 647,000 hospitalizations, plus estimated 37.4 million - 42.9 million flu illness, representing a week or more of suffering, mean little, and for every study he can cite, there are literally dozens that show the value of the flu vaccine (CDC, 2019ab). Plus, overwhelming evidence find the flu a significant risk for both the pregnant woman and the fetus (CDC, 2019c). Note that the CDC website gives references to the above. In addition, the estimates, for instance, of deaths, are because if someone dies of pneumonia or heart disease, hospitals don\u2019t always do labs for flu if symptoms have subsided. For instance, flu damages the epithelials of the lungs allowing for pneumonia-causing bacteria to attack. Estimates overall are based on lab confirmations of flu, thus flu season, and comparisons of instances of pneumonia and heart disease when weak flu season, serious flu season, and off-flu season. The methodology is quite involved, which is why ranges are given. \u003C\/p\u003E\n\u003Cp\u003EOne last thought. Statistical significance doesn\u2019t mean importance, it means that despite the best efforts to equalize groups on all variables except the one of interest, random chance means that the results of a study could be the result of some unmeasured variable(s), not the variable being studied. So, a p = 0.05 means that one would expect the result to occur 5% of the time from uncontrolled variables, which is why various replications are the sine qua non of science, not cherry-picking the studies that confirm one\u0027s bias ! ! ! \u003C\/p\u003E\n\u003Cp\u003EReferences:\u003C\/p\u003E\n\u003Cp\u003ECDC (2019a Feb 12). Pregnant Women \u0026amp; Influenza (Flu). Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/flu\/highrisk\/pregnant.htm\u0022\u003Ehttps:\/\/www.cdc.gov\/flu\/highrisk\/pregnant.htm\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (2019b Feb 26). Flu Symptoms \u0026amp; Complications. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/flu\/symptoms\/symptoms.htm\u0022\u003Ehttps:\/\/www.cdc.gov\/flu\/symptoms\/symptoms.htm\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC (2019c May 10). Influenza. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/flu\/\u0022\u003Ehttps:\/\/www.cdc.gov\/flu\/\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EChambers CD, Johnson DL, Xu R et al. (2016). Safety of the 2010\u201311, 2011\u201312, 2012\u201313, and 2013\u201314 seasonal influenza vaccines in pregnancy: Birth defects, spontaneous abortion, preterm delivery, and small for gestational age infants, a study from the cohort arm of VAMPSS. Vaccine; 34: 4443-4449. Available at: \u003Ca href=\u0022https:\/\/www.aaaai.org\/Aaaai\/media\/MediaLibrary\/PDF%20Documents\/About\/Chambers-Safety-of-the-2010-11-2013-14-seasonal-flu-vaccines-Vaccine2016.pdf\u0022\u003Ehttps:\/\/www.aaaai.org\/Aaaai\/media\/MediaLibrary\/PDF%20Documents\/About\/Cha...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECunningham AS (2017 Sep 22). Vaccine authorities don\u0027t want to know about adverse effects. II. BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/358\/bmj.j4100\/rr-6\u0022\u003Ehttps:\/\/www.bmj.com\/content\/358\/bmj.j4100\/rr-6\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EDonahue JG, Kieke BA, King JP, DeStefano et al. (2017 Sep 25). Association of spontaneous abortion with receipt of inactivated influenza vaccine containing H1N1pdm09 in 2010\u201311 and 2011\u201312. Vaccine; 35 (40): 5314-5322. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6501798\/\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6501798\/\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EDonahue JG, Kieke BA, King JP et al. (2018 Apr 19). Response to three Letters to the Editor regarding: Donahue JG, et al. \u2018\u2018Association of spontaneous abortion with receipt of inactivated influenza vaccine containing H1N1pdm09 in 2010\u201311 and 2011\u201312\u201d. Vaccine 35 (2017) 53-14\u20135322. Vaccine; 36(17): 2231-2232.\u003C\/p\u003E\n\u003Cp\u003EDonahue J (2019 Feb 27). Case-Control Study of Inactivated Influenza Vaccine and Spontaneous Abortion in the Vaccine Safety Datalink, 2012-13, 2013-14, and 2014-15. Slide Show Presentation to Advisory Committee on Immunization Practice. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/vaccines\/acip\/meetings\/downloads\/slides-2019-02\/flu-5-Donahue-508.pdf\u0022\u003Ehttps:\/\/www.cdc.gov\/vaccines\/acip\/meetings\/downloads\/slides-2019-02\/flu-...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EEaton A, Lewis N, Fireman B et al. (2018). Birth outcomes following immunization of pregnant women with pandemic H1N1 influenza vaccine 2009\u20132010. Vaccine; 36: 2733-2739. ABSTRACT Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28917536\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28917536\u003C\/a\u003E [Note I have the paper]\u003C\/p\u003E\n\u003Cp\u003EFell DB, Platt RW, Lanes A et al. (2015 Jan). Fetal death and preterm birth associated with maternal influenza vaccination: systematic review. BJOG : an international journal of obstetrics and gynaecology; 122(1): 17-26. Available at: \u003Ca href=\u0022https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/epdf\/10.1111\/1471-0528.12977\u0022\u003Ehttps:\/\/obgyn.onlinelibrary.wiley.com\/doi\/epdf\/10.1111\/1471-0528.12977\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EGiles ML, Krishnaswamy S, Macartney K, Cheng A (2019). The safety of inactivated influenza vaccines in pregnancy for birth outcomes: a systematic review. Human Vaccines \u0026amp; Immunotherapeutics; 15(3): 687-699. Available at: \u003Ca href=\u0022https:\/\/www.tandfonline.com\/doi\/pdf\/10.1080\/21645515.2018.1540807?needAccess=true\u0022\u003Ehttps:\/\/www.tandfonline.com\/doi\/pdf\/10.1080\/21645515.2018.1540807?needAc...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EH\u00e5berg SI, Trogstad L, Gunnes N et al. (2013 Jan 24). Risk of fetal death after pandemic influenza infection or vaccination during pregnancy. New England Journal of Medicine; 368(4): 333-340. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3602844\/pdf\/nihms442759.pdf\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3602844\/pdf\/nihms442759.pdf\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ELouik C, Ahrens K, Kerr S et al. (2013). Risks and safety of pandemic H1N1 influenza vaccine in pregnancy: Exposure prevalence, preterm delivery, and specific birth defects. Vaccine; 31: 5033-5040. Available at: \u003Ca href=\u0022https:\/\/www.aaaai.org\/Aaaai\/media\/MediaLibrary\/PDF%20Documents\/About\/H1N1_Vaccine_SEC_final_2013.pdf\u0022\u003Ehttps:\/\/www.aaaai.org\/Aaaai\/media\/MediaLibrary\/PDF%20Documents\/About\/H1N...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EOffit PA (2017 Sep 24). The Pregnancy Vaccine Scare That Should Have Never Been: Why that CDC study on flu shots during the first trimester should never have been published. The Daily Beast. Available at: \u003Ca href=\u0022https:\/\/www.thedailybeast.com\/the-pregnancy-vaccine-scare-that-should-have-never-been\u0022\u003Ehttps:\/\/www.thedailybeast.com\/the-pregnancy-vaccine-scare-that-should-ha...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EOmer SB (2017). Maternal Immunization. New England Journal of Medicine; 376: 1256-67.\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E15 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-7 views-row-odd\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-27\u0022\u003E\u003Ch3\u003ERe: US county bars unvaccinated children from public spaces amid measles emergency\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EI note Joel Harrison\u0027s comments about me [1]. I would point out my previous reply [2] which was not about how I read Offit\u0027s article but how it was used to persuade people about the safety of administering multiple vaccines by Offit himself others, and with detailed documentation. When it is acknowledged, at least in some cases, that a single vaccine can carry a serious risk (smallpox, anthrax, yellow fever immediately come to mind) I am not sure that the calculation was ever anything more than a red-herring, but it was manifestly used by professionals when addressing the public to reassure them about the safety of multiple vaccine exposure - indeed Harrison still seems to think that it is reassuring - and I am simply pointing this out.\u003C\/p\u003E\n\u003Cp\u003E[1] Joel A Harrison, \u0027Re: US county bars unvaccinated children from public spaces amid measles emergency\u0027, 10 May 2019, \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-23\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-23\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003E[2] John Stone, \u0027Reply to Joel Harrison - Offit\u0027s calculation was misleading\u0027, 8 May 2019, \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-11\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-11\u003C\/a\u003E\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E15 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n John Stone \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n UK Editor \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n London N22 \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-8 views-row-even\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-25\u0022\u003E\u003Ch3\u003ERe: US county bars unvaccinated children from public spaces amid measles emergency\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EResponse 2 to Dr Anand\u003C\/p\u003E\n\u003Cp\u003EAnand writes: \u201cDear all interested in immunisation against a particular disease - by full, free, informed consent of the person at risk of that particular disease.\u201d\u003C\/p\u003E\n\u003Cp\u003EAnand continues to ignore that we live in communities, which means rights as well as responsibilities. As I wrote earlier, there are children who can\u2019t be vaccinated, e.g., autoimmune diseases, chemotherapy for cancer, or other genetic disorders that reduce immune system\u2019s response to vaccines. Many children are alive today who only a generation or two ago would not be, e.g., low birthweight, very low birthweight, who have problems; but can live reasonably healthy long lives. How do we protect these kids? Should their parents home school them, not take them to parks, schools, shopping, Disneyland, even doctor\u2019s offices? No visitors to the home? Do their lives not matter? Don\u2019t they deserve a quality of life? As I wrote previously, besides just a sense of community, what if the shoe were on the other foot, i.e., there but for the Grace of G-d go I? (Harrison, 2019)\u003C\/p\u003E\n\u003Cp\u003EPerhaps Anand was a supporter of Margaret Thatcher who said: \u201cthere is no such thing as society. There are individual men and women, and there are families. . . people must look to themselves first. It\u2019s our duty to look after ourselves and then, also to look after our neighbour (Thatcher, 1987). Not to go too far afield; after Brits had gone through the Great Depression and World War II together, they established the National Health Service, among the best in the world; but Thatcher almost destroyed it. Despite claims to the contrary, health care doesn\u2019t fit into a market model, it is a \u201cpublic good\u201d [community, society] (Arrow, 1963; Harrison, 2018; Rice, 2015). But even Thatcher\u2019s quote says after we have looked after ourselves, we should look after our neighbors. Or how about Rabbi Hillel from 2000 years ago: \u201c\u201cIf I am not for myself, who will be for me? If I am not for others, what am I? And if not now, when?\u201d\u003C\/p\u003E\n\u003Cp\u003EAnand writes: \u201cIt is stated that the \u201chesitants\u0022 are mostly well-educated.\u003Cbr \/\u003E\nMight I suggest that cultural anthropologists be kept out of it? Margaret Mead is sometimes invoked. But it is forgotten that she did not write about Samoa by reading about Samoans, nor did she pay flying visits only. Could it be that the well-educated parents take umbrage at being bullied? Being told that they are enemies of \u201c\u003C\/p\u003E\n\u003Cp\u003EThe studies weren\u2019t conducted by cultural anthropologists (e.g., Hornsey, 2018; Khazan, 2014; LaVito, 2019; Oracknows, 2015; Warner, 2017; Yang). A number of studies have found that one major group of antivaccinationists is comprised of well-educated, middle-class whites, but not all studies agree; but who cares? I actually in younger years read Margaret Mead, Ruth Benedict, and Franz Boas, plus other anthropologists, so what? Is it bullying to outlaw storage of large amounts of combustibles in one\u0027s garage? Is it bullying to quarantine those returning from, for instance, countries with Ebola outbreaks? Is it bullying to deny people the right to drink and drive? After all, there are those who can hold their liquor??? Since many vaccine-preventable diseases are contagious long before they become symptomatic, should we quarantine anyone not vaccinated who travels abroad? How would this work with those traveling to and from Mexico and Canada? Again, in communities, we have rights and responsibilities. The overwhelming evidence supports that vaccines confer exponentially more benefit compared to minuscule serious risks, autism not one of them. As part of a community, should individual parents be allowed to rely on others vaccinating their kids? As long as vaccine rates remain high, they are still no guarantee that an innocent child who can\u2019t be vaccinated won\u2019t become infected by someone who voluntarily refused vaccination. The recent outbreak of measles at Disneyland was attributed to a non-vaccinated kid (Zipprich, 2015). What if parents brought their child who had just successfully been treated for cancer to Disneyland and he\/she became infected? The consequences may have been dire. Whether low vaccination rates cluster among white, educated, well-off suburbanites or elsewhere, they put everyone at risk ! ! !\u003C\/p\u003E\n\u003Cp\u003EAnand writes: \u201cI have it from an unimpeachable source that in Germany, there is licensed, a monovalent MEASLES Vaccine. But it is not available. Why, I wonder. It may be costly. But might I suggest that the vaccine may be made available to those who are willing to pay?\u201d\u003C\/p\u003E\n\u003Cp\u003EIt is not available in the US because the companies decided it wasn\u2019t cost-effective to produce (Kimberlin, 2009). And in the US it is illegal to import any drug not approved by the FDA, so companies producing monovalent measles vaccine abroad would have to spend a fortune to get it through the FDA approval process (Congressional Research Service, 2018). As I\u2019ve written before, the safety profile for the MMR is the same as for the monovalent measles vaccine. And what happens if parents only get their kids the measles vaccine? Then they risk mumps and rubella, both, though often, not always, benign, could have serious sequelae for the kids who can\u2019t be vaccinated because of compromised immune systems. \u003C\/p\u003E\n\u003Cp\u003EAnand writes: \u201cThe WHO knows full well that in India it quite happily supports MEASLES - RUBELLA vaccination. Yet , in Europe, it has to be MMR.\u201d \u003C\/p\u003E\n\u003Cp\u003EActually, India is in the process of adopting the MMR.(Bhatnagar, 2014; Bandyopadhyay, 2017; Gomber, 2011; Shah, 2017). And I guess if currently India only vaccinated for measles, then Anand would question why add Rubella.\u003C\/p\u003E\n\u003Cp\u003EReferences\u003C\/p\u003E\n\u003Cp\u003EArrow KJ (1963 Dec). Uncertainty and the Welfare Economics of Medical Care. The American Economic Review; 53(5): 141-149. Available at: \u003Ca href=\u0022https:\/\/www.who.int\/bulletin\/volumes\/82\/2\/PHCBP.pdf\u0022\u003Ehttps:\/\/www.who.int\/bulletin\/volumes\/82\/2\/PHCBP.pdf\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EBandyopadhyay B (2017 Feb 19). All you wanted to know about MMR vaccine but never asked. Bangalore Mirror. Available at: \u003Ca href=\u0022https:\/\/bangaloremirror.indiatimes.com\/news\/state\/all-you-wanted-to-\u0022\u003Ehttps:\/\/bangaloremirror.indiatimes.com\/news\/state\/all-you-wanted-to-\u003C\/a\u003E\u2026-mmr-vaccine-but-never-asked\/articleshowprint\/57070816.cms?prtpage=1\u003C\/p\u003E\n\u003Cp\u003EBhatnagar N, Kaur R, Gupta M, Sharma D (2014 Jun 15). Introducing Combined Measles, Mumps and Rubella Vaccine in Chandigarh, India: Issues and Concerns! Indian Pediatrics; 51: 441-443. Available at: \u003Ca href=\u0022http:\/\/medind.nic.in\/ibv\/t14\/i6\/ibvt14i6p441.pdf\u0022\u003Ehttp:\/\/medind.nic.in\/ibv\/t14\/i6\/ibvt14i6p441.pdf\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECongressional Research Service (2018 Dec 21). Prescription Drug Importation. Available at: \u003Ca href=\u0022https:\/\/fas.org\/sgp\/crs\/misc\/IF11056.pdf\u0022\u003Ehttps:\/\/fas.org\/sgp\/crs\/misc\/IF11056.pdf\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EGomber S, Arora SK, Das S, Ramachandran VG (2011 Sep). Immune response to second dose of MMR vaccine in Indian Children. Indian Journal of Medical Research; 154(3): 302-306. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3193710\/\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3193710\/\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2018 Aug 10). The Case for A Non-Profit Single-Payer Healthcare System. Physicians for a National Health Program. Available at: \u003Ca href=\u0022http:\/\/pnhp.org\/news\/the-case-for-a-non-profit-single-payer-healthcare-system\/\u0022\u003Ehttp:\/\/pnhp.org\/news\/the-case-for-a-non-profit-single-payer-healthcare-s...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019 Mar 31). Response to John Stone. BMJ Rapid Response. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-3\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-3\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHornsey MJ, Harris EA, Fielding KS (2018). The Psychological Roots of Anti-Vaccination Attitudes: A 24-Nation Investigation. Health Psychology; 37(4): 307-315. Available at: \u003Ca href=\u0022https:\/\/www.apa.org\/pubs\/journals\/releases\/hea-hea0000586.pdf\u0022\u003Ehttps:\/\/www.apa.org\/pubs\/journals\/releases\/hea-hea0000586.pdf\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EKhazan O (2014 Sep 16). Wealthy L.A. Schools\u0027 Vaccination Rates Are as Low as South Sudan\u2019s: Hollywood parents say not vaccinating makes \u0022instinctive\u0022 sense. Now their kids have whooping cough. The Atlantic. Available at: \u003Ca href=\u0022https:\/\/www.theatlantic.com\/health\/archive\/2014\/09\/wealthy-la-schools-vaccination-rates-are-as-low-as-south-sudans\/380252\/\u0022\u003Ehttps:\/\/www.theatlantic.com\/health\/archive\/2014\/09\/wealthy-la-schools-va...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EKimberlin DW, Bocchini JA (2009 Dec). Monovalent vaccines no longer available for measles, mumps, rubella. AAP News. Available at: \u003Ca href=\u0022http:\/\/www.aappublications.org\/content\/30\/12\/9.1\u0022\u003Ehttp:\/\/www.aappublications.org\/content\/30\/12\/9.1\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ELaVito A (2019 Mar 19). Here\u02bcs where parents are refusing to get their children vaccinated. CNBC. Available at: \u003Ca href=\u0022https:\/\/www.cnbc.com\/2019\/03\/28\/heres-where-parents-are-refusing-to-get-their-children-vaccinated.html\u0022\u003Ehttps:\/\/www.cnbc.com\/2019\/03\/28\/heres-where-parents-are-refusing-to-get-...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EOracknows (2015 Jun 4). The faces of antivaccine parents: Overwhelmingly a!uent, white, and suburban. Science Blogs. Available at: \u003Ca href=\u0022https:\/\/scienceblogs.com\/insolence\/2015\/06\/04\/antivaccine-parents-overwhelmingly-affluent-white-and-suburban\u0022\u003Ehttps:\/\/scienceblogs.com\/insolence\/2015\/06\/04\/antivaccine-parents-overwh...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ERabbi Hillel. Available at: \u003Ca href=\u0022https:\/\/www.goodreads.com\/quotes\/556948-if-i-am-not-for-myself-who-will-be-for\u0022\u003Ehttps:\/\/www.goodreads.com\/quotes\/556948-if-i-am-not-for-myself-who-will-...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ERice T, Unruh L (2015). The Economics of Health Reconsidered, Fourth Edition. Health Administration Press.\u003C\/p\u003E\n\u003Cp\u003EShah N, Parikh R, Casabona G, Kolhapure S (2017). A New Combined Vaccine Against Measles, Mumps, Rubella and Varicella in India. Indian Pediatrics; 54: 1041-1046. Available at: \u003Ca href=\u0022https:\/\/www.indianpediatrics.net\/dec2017\/dec-1041-1046.htm\u0022\u003Ehttps:\/\/www.indianpediatrics.net\/dec2017\/dec-1041-1046.htm\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EThatcher M (1987 Oct 31). Epitaph for the eighties? \u201cthere is no such thing as society\u201d. Sunday Times. Available at: \u003Ca href=\u0022https:\/\/briandeer.com\/social\/thatcher-society.htm\u0022\u003Ehttps:\/\/briandeer.com\/social\/thatcher-society.htm\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EWarner EL, Ding Q, Pappas LM et al. (2017). White, affluent, educated parents are least likely to choose HPV vaccination for their children: a cross-sectional study of the national Immunization Study \u2013 teen. BMC Pediatrics; 17. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5710112\/pdf\/12887_2017_Article_953.pdf\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5710112\/pdf\/12887_2017_Arti...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EYang YT, Delamater PL, Leslie TF, Mello MM (2016). Sociodemographic Predictors of Vaccination Exemptions on the Basis of Personal Belief in California. American Journal of Public Health: 106: 172-177. Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4695929\/pdf\/AJPH.2015.302926.pdf\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4695929\/pdf\/AJPH.2015.30292...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EZipprich J, Winter K, Hacker J et a. (2015 Feb 20). Measles Outbreak \u2014 California, December 2014\u2013February 2015. Morbidity and Mortality Weekly Report (MMWR); 64(06): 153-154. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6406a5.htm\u0022\u003Ehttps:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6406a5.htm\u003C\/a\u003E\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E15 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-9 views-row-odd\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-23\u0022\u003E\u003Ch3\u003ERe: US county bars unvaccinated children from public spaces amid measles emergency\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EResponse to John Stone\u2019s \u201cOffit\u2019s calculation was misleading\u201d\u003C\/p\u003E\n\u003Cp\u003EStone continues not to understand that even common sense would tell most reasonable people that Offit could not have been talking about 10,000 actual vaccines. We currently give kids in the US 17 and I couldn\u2019t come up with even 50 current infectious diseases that I would consider devoting 100s of millions of dollars to develop vaccines for all America\u2019s kids. As I wrote previously, Stone seems to be incapable of understanding context. He focuses on one sentence at a time. I\u2019ve been going to a local YMCA gym for over 15 years where a range of people from high school students to senior citizens participate. I\u2019ve asked them if someone told them that kids could handle 10,000 vaccines at once, what do they think. They laugh and say how impossible that would be. Then answered something to the effect that it was explaining how our immune systems work. \u003C\/p\u003E\n\u003Cp\u003EStone quotes from himself: \u201c\u0022There were several obvious things wrong with Offit\u2019s claim that 10,000 or 100,000 vaccines administered to an infant in one go might be safe. Offit was comparing routine exposure to environmental pathogens, with cocktails of serious disease derived pathogens; it took no account, for example, of the use of adjuvants to boost the antigens and the route of administration was nothing like routine exposure to pathogens in the environment i.e. in most cases injected when normally we have skin, the digestive system, the lungs which have evolved to protect us\u2026\u0022\u003C\/p\u003E\n\u003Cp\u003EWhat Stone seems not to understand is that the \u201ccocktails of serious disease derived pathogens\u201d are either killed or attenuated. Attenuated means they have been passaged either through different animals, tissues, or cell cultures. By doing this they have mutated until they can only multiply a few times in our bodies, thus, allowing our immune systems to recognize them; but they can\u2019t do any damage. He also seems not to understand that our immune systems involve around 10 million different B-cells circulating throughout our bodies making complete rounds in a few hours, including our intestines, muscles, and skin. And various antigen-presenting cells, those that clasp on to foreign microbes, process them, and then present them to antibodies, exist everywhere in our bodies; especially in layers of our skin. And he ignores what I wrote that on average a child is exposed to up to 5 - 6,000 potentially dangerous microbes daily, microbes that are neither killed nor attenuated; but full strength. As for adjuvants, infants get far more aluminum from their mother\u2019s milk or formula in a couple of days than the minute amounts in vaccines. And on and on it goes.\u003C\/p\u003E\n\u003Cp\u003EStone goes on to write: \u201cbut with so many products on the schedule and so many more in the pipeline there is surely no longer any rational way of regarding this as anything but over-medication.\u201d\u003C\/p\u003E\n\u003Cp\u003EPrior to vaccines, during the 1950s, around 95% of young kids had experienced all of the current vaccine-preventable diseases. According to my parents, I had them all, except polio, though I may have experienced a subclinical case as we had a major epidemic in my home town when I was an infant. And if we had not had the diphtheria vaccine and smallpox vaccines, the toll would have been heartbreaking. \u201cThe United States recorded 206,000 cases of diphtheria in 1921, resulting in 15,520 deaths (CDC Clinicians).\u201d And, as I wrote in a previous RR, though variola minor (Smallpox) was prevalent in the US with only around 1% fatalities, people did bring in variola major with deaths and there was no reason that variola major could not have become dominant again with up to 30% fatalities. Prior to the successful eradication of smallpox by the WHO, an estimated 300 - 500 million in the Third World died from it.\u003C\/p\u003E\n\u003Cp\u003EStone writes: \u201cIt is unusual for a correspondent to make so many assertions about another as Joel Harrison has done here about myself, and a lot of it seems rather speculative and regrettable.\u201d \u003C\/p\u003E\n\u003Cp\u003EI could care less about John Stone, it is what he represents. Stone is the UK Editor of Age of Autism, claiming to provide people with scientifically valid arguments. What does Stone tell you about the unscientific, illogical, and lacking in common sense of antivaccinationists??? And his use of word \u201cspeculative\u201d where I have in detail, e.g., explained how the immune system works, refuting his claims is just another example of Stone\u2019s idiosyncratic use of the English language. In an exchange on another blog where I asked him if he had ever studied any of the relevant sciences underlying vaccinology, he accused me of an ad hominem attack. And if anyone reads my RRs, I try to address each and every claim made by antivaccinationists, whereas Stone concentrates on one or two. In other words, he seems incapable of entering into a rational dialogue.\u003C\/p\u003E\n\u003Cp\u003EWith hindsight, should Paul Offit have worded the one sentence differently, e.g., \u201cBased on what we know about the immune system, which can handle the equivalent of 10,000 or even 100,000 vaccines, the 17 we give our kids or even a few more presents absolutely NO challenge.\u201d Yep, then people like Stone who do not understand the context, who do not change even when it is explained, will just find something else. Stone doesn\u2019t seem to understand that vaccines are just applied immunology. And was the use of 10,000 to allay parents concerns, yep.\u003C\/p\u003E\n\u003Cp\u003EFor those following this exchange of RRs, I suggest clicking on Order \u201cAscending\u201d, Items per page \u201c20\u201d, then \u201cApply\u201d. I think it will be clear just how Stone avoids\/ignores what I wrote.\u003C\/p\u003E\n\u003Cp\u003EFor those interested, there is a great little book, less than 150 pages and well-illustrated that introduces the immune system: Lauren Sompayrac (2016). How The Immune System Works (5th Edition).\u003C\/p\u003E\n\u003Cp\u003EReferences:\u003C\/p\u003E\n\u003Cp\u003ECDC Diphtheria. Clinicians. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/diphtheria\/clinicians.html\u0022\u003Ehttps:\/\/www.cdc.gov\/diphtheria\/clinicians.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019 May 7). \u201cSmallpox\u201d Response to John Stone \u0026amp; Elizabeth M. Hart. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-13\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-13\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019 May 7). \u201cImmune Sytem\u201d\/\u201cContext\u201d Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-14\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rr-14\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EStone\u2019s Claim of \u201cCareful Reading\u201d Available at: \u003Ca href=\u0022https:\/\/www.ageofautism.com\/2017\/02\/experts-respond-to-dr-david-amaral-mind-institute.html\u0022\u003Ehttps:\/\/www.ageofautism.com\/2017\/02\/experts-respond-to-dr-david-amaral-m...\u003C\/a\u003E [Click on Edit, Search, then type \u201cAd Hominem\u201d]\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E10 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003Cdiv class=\u0022views-row views-row-10 views-row-even views-row-last\u0022\u003E\n \r\n\u003Cdiv class=\u0022node node-highwire-comment node-promoted clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022row rr-header\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022rr-left-column\u0022 class=\u0022\u0022\u003E\r\n\r\n \r\n \u003Cdiv class=\u0022response-title\u0022\u003E\r\n \u003Ca href=\u0022\/content\/364\/bmj.l1481\/rr-22\u0022\u003E\u003Ch3\u003ERe: US county bars unvaccinated children from public spaces amid measles emergency\u003C\/h3\u003E\r\n \u003C\/a\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \r\n \r\n \u003Cdiv class=\u0022content\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022response-body\u0022\u003E\r\n \u003Cp\u003EResponse to Allan S. Cunningham\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cDoes he know that a substantial proportion of cases of paralytic polio has been attributable to injections of vaccines or antibiotics?\u201d\u003C\/p\u003E\n\u003Cp\u003EActually, I have ca 40 papers on provocation\/injections\/antibiotics and polio, including the ones you list, plus a number of chapters in books. The first documented instances go back to Germany early part of 20th Century when infants received injections of neosalvarsan (an organic arsenic compound) and in 1932 in Western Samoa when the Rockefeller Institute initiated a campaign against Yaws, giving two injections per year of neoarsphenamine to everyone who showed signs of yaws (Smallman-Raynor (2006). And there is some documentation that other injections have shown a causal connection with polio. You also left out the association with tonsillectomies. The response among many health professionals was simply to postpone injections and tonsillectomies until after polio season (Mawdsley, 2013). Note that research exonerated antibiotics (arsenic-based were already no longer used) (ibid). \u201c\u201cThe decision to reform public health policy in the US was handled differently in various areas, but appears to have been taken with great care, since it was clear that withholding certain immunisations would jeopardise herd immunity,\u201d said Dr Mawdsley. \u201cDelaying injections until after polio epidemics subsided was an expedient means to achieve a compromise.\u201d (Mawdsley (2013b) However, both injections and tonsillectomies only affected a small, not substantial, proportion of kids, based on timing of exposure to polio virus and injection\/tonsillectomy. One also has to take into consideration the devastating mortality from just diphtheria alone prior to vaccinations, \u201cThe United States recorded 206,000 cases of diphtheria in 1921, resulting in 15,520 deaths (CDC Clinicians).\u201d With the advent of the Salk vaccine and later the Oral Sabin vaccine, provocational polio paralysis disappeared. And, as I discuss in an article. post-polio syndrome involved many who did not become paralyzed when first infected (Harrison, 2018b). So, I\u2019m quite aware of provocation paralytic polio; but also aware of the number of cases vs the risks from other vaccine-preventable diseases and that once the polio vaccine was introduced, paralytic cases of polio disappeared in the US. With hindsight, it would have been great if earlier on injections and tonsillectomies had been postponed until after polio season; but the fact remains that, tragic as it was, the number of provocation polio paralysis cases paled beside the number of deaths, suffering, and disability that would have resulted if vaccines had not existed.\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cWill he acknowledge the possibility that this might also be true of acute flaccid myelitis\/AFM, the devastating polio-like disease now afflicting children?\u201d \u003C\/p\u003E\n\u003Cp\u003EAcute flaccid myelitis has been mainly attributed to a couple of enteroviruses. There exists ca. 100 different strains of enterovirus and when labs were first used to confirm polio back in the 1950s, some cases of paralysis were already attributed to other enteroviruses (Harrison, 2018b). Sporadic cases of non-polio acute flaccid paralysis have been with us for decades. However, studies have found that \u201cthe genome had undergone a rearrangement from the initial Fermon strain in the spacer region of the 5\u2019 UTR, which is known to affect the translational efficiency and thought to increase the virulence (Cassidy, 2018; see also Rao, 2012). In a Rapid Response, Cunningham claimed: \u201c\u201cThey also say that they are continuing to investigate the possibility of an association, but the AFM Patient Summary Forms that they supply to US state health departments contain no questions about injections or vaccinations.\u201d NOT TRUE (Iannelli, 2018). \u201cIn addition, AFM cases are seen at a variety of ages and not at an age when a particular childhood vaccine is regularly given. The average age of AFM cases in the largest published reports from the US is 7 and 9 years, and the age of reported AFM cases ranges from 6 months to 21 years and older. So, the ages of AFM cases vary and are past the time when most childhood vaccines are routinely given.\u201d (Duchin, 2016) Blaming vaccines ignores the fact that viruses mutate. It is also possible that due to more infants surviving, even with various disabilities, that genetic predisposition plays a role.\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cDoes he believe that our knowledge of adverse vaccine effects is complete?\u201d\u003C\/p\u003E\n\u003Cp\u003EComplete? This question is problematic. At this very moment, post-marketing surveillance of vaccines continues, not just VAERS, for instance, Vaccine Safety Datalink that collects real time data on several million Americans (CDC Vaccine Safety Publications). Check out PubMed with almost 19,000 entries, some reviews, some editorials, but many research articles. However, at this point the overwhelming evidence tells us that the benefit\/cost ratio for vaccines is exponential. Would I like to have vaccines that approach 100% effectiveness and 0% adverse events. You betcha; but I live in the real world.\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cDoes he believe that every vaccine on the US immunization schedule is vital to the health of every American child?\u201d\u003C\/p\u003E\n\u003Cp\u003EAnother problematic question. Since each of the current vaccines prevent or reduce the severity of diseases with potentially devastating consequences, and herd immunity protects even the most vulnerable, plus safety studies show them to be very safe, we should not play G-d and choose which children\u2019s welfare is more important.\u003C\/p\u003E\n\u003Cp\u003ECunningham writes: \u201cWould he agree that, in addition to humanitarian motives, there are also non-humanitarian motives driving our immunization programs?\u201d\u003C\/p\u003E\n\u003Cp\u003EI\u2019ve answered this in a previous RR and in more detail in an article (Harrison, 2019; 2018a). No international conspiracy exists to further the \u201cprofits\u201d of the pharmaceutical industry ! ! !\u003C\/p\u003E\n\u003Cp\u003EReferences:\u003C\/p\u003E\n\u003Cp\u003ECassidy H, Poelman R, Knoester M et al (2018 Nov 13). Enterovirus D68 \u2013 The New Polio? Frontiers in Microbiology. Available at: \u003Ca href=\u0022https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2018.02677\/full\u0022\u003Ehttps:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2018.02677\/full\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC Diphtheria. Clinicians. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/diphtheria\/clinicians.html\u0022\u003Ehttps:\/\/www.cdc.gov\/diphtheria\/clinicians.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ECDC Vaccine Safety Publications. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/vaccinesafety\/research\/publications\/index.html\u0022\u003Ehttps:\/\/www.cdc.gov\/vaccinesafety\/research\/publications\/index.html\u003C\/a\u003E [click on CDC Vaccine Safety Publications Years]\u003C\/p\u003E\n\u003Cp\u003ECDC Vaccine Safety Datalink. Available at: \u003Ca href=\u0022https:\/\/www.cdc.gov\/vaccinesafety\/ensuringsafety\/monitoring\/vsd\/index.html\u0022\u003Ehttps:\/\/www.cdc.gov\/vaccinesafety\/ensuringsafety\/monitoring\/vsd\/index.html\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EDuchin J (2016 Nov 7). Why health care providers \u0026amp; public health professionals say vaccines are not the cause of recent acute flaccid myelitis (AFM) cases. Public Health Insider. Available at: \u003Ca href=\u0022https:\/\/publichealthinsider.com\/2016\/11\/07\/why-health-care-providers-public-health-professionals-say-vaccines-are-not-the-cause-of-recent-acute-flaccid-myelitis-afm-cases\/\u0022\u003Ehttps:\/\/publichealthinsider.com\/2016\/11\/07\/why-health-care-providers-pub...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2018a Feb 26). The So-Called Vaccine Debate: False Balance in The San Diego Union-Tribune. Science-Based Medicine. Available at: \u003Ca href=\u0022https:\/\/n1s1t23sxna2acyes3x4cz0h-wpengine.netdna-ssl.com\/wp-content\/uploads\/2018\/02\/Joel-A.-Harrison-2018-Feb-26.-The-So-Called-Vaccine-Debate.pdf\u0022\u003Ehttps:\/\/n1s1t23sxna2acyes3x4cz0h-wpengine.netdna-ssl.com\/wp-content\/uplo...\u003C\/a\u003E [go to page 5]\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2018b Nov 10). Wrong About Polio: A Review of Suzanne Humphries, MD and Roman Bystrianyk\u2019s \u201cDissoveing Illusions\u201d Part 1. Available at: \u003Ca href=\u0022https:\/\/n1s1t23sxna2acyes3x4cz0h-wpengine.netdna-ssl.com\/wp-content\/uploads\/2018\/11\/Part-1-Joel-A.-Harrison-2018-Oct-28.-Wrong-About-Polio-A-Review-of-Suzanne-Humphries-MD-and-Roman-Bystrianyk-\u0022\u003Ehttps:\/\/n1s1t23sxna2acyes3x4cz0h-wpengine.netdna-ssl.com\/wp-content\/uplo...\u003C\/a\u003E\u201cDissolving-Illusions\u201d-long-version.pdf\u003C\/p\u003E\n\u003Cp\u003EHarrison JA (2019 Mar 31). Response to John Stone. The BMJ Rapid Responses. Available at: \u003Ca href=\u0022https:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rapid-responses\u0022\u003Ehttps:\/\/www.bmj.com\/content\/364\/bmj.l1481\/rapid-responses\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EIannelli V (2018 Nov 2). The BMJ Asks If Injections Are Part of the \u201cMystery\u201d of Acute Flaccid Myelitis\/AFM. Vaxopedia. Available at: \u003Ca href=\u0022https:\/\/vaxopedia.org\/2018\/11\/02\/the-bmj-asks-if-injections-are-part-of-the-mystery-of-acute-flaccid-myelitis-afm\/\u0022\u003Ehttps:\/\/vaxopedia.org\/2018\/11\/02\/the-bmj-asks-if-injections-are-part-of-...\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003EMawdsley SD (2013a). Balancing Risks: Childhood Inoculations and America\u2019s Response to the Provocation of Paralytic Polio. Social History of Medicine; 26(4): 759-778.\u003C\/p\u003E\n\u003Cp\u003EMawdsley SD (2013b). Polio provocation \u2013 the health debate that refused to go away. University of Cambridge. Available at: \u003Ca href=\u0022https:\/\/www.cam.ac.uk\/research\/features\/polio-provocation-the-health-debate-that-refused-to-go-away\u0022\u003Ehttps:\/\/www.cam.ac.uk\/research\/features\/polio-provocation-the-health-deb...\u003C\/a\u003E\u003Cbr \/\u003E\nPubMed (2019 May 9). Search Box: \u201cVaccine Safety\u201d Available at: \u003Ca href=\u0022https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=vaccine+safety\u0022\u003Ehttps:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=vaccine+safety\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ERao CD, Yergolkar P, Shankarappa KS (2012 Nov). Antigenic Diversity of Enteroviruses Associated with Nonpolio Acute Flaccid Paralysis, India, 2007\u20132009. Emerging Infectious Diseases; 18(11): 1833-1840. Available at: \u003Ca href=\u0022https:\/\/wwwnc.cdc.gov\/eid\/article\/18\/11\/11-1457_article\u0022\u003Ehttps:\/\/wwwnc.cdc.gov\/eid\/article\/18\/11\/11-1457_article\u003C\/a\u003E\u003C\/p\u003E\n\u003Cp\u003ESmallman-Raynor, Cliff AD (2006). Poliomyelitis: Emergence to Eradication. Oxford Geographical and Environmental Studies.\u003C\/p\u003E\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-competing\u0022\u003E\r\n \u003Cp\u003E\u003Cstrong\u003ECompeting interests: \u003C\/strong\u003E\r\n No competing interests\u003C\/p\u003E\r\n \u003C\/div\u003E\r\n\r\n \r\n \u003C\/div\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-right-column\u0022 class=\u0022\u0022\u003E\r\n \u003Cdiv class=\u0022response-date\u0022\u003E\r\n \u003Cstrong\u003E09 May 2019\u003C\/strong\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-author\u0022\u003E\r\n Joel A. Harrison \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-occupation\u0022\u003E\r\n Long-Retired Epidemiologist \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-other_authors\u0022\u003E\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-affiliation\u0022\u003E\r\n None \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-address\u0022\u003E\r\n I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022twitter-address\u0022\u003E\r\n \u003Ca href=\u0022https:\/\/twitter.com\/\u0022\u003E\u003C\/a\u003E \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022response-links\u0022\u003E\r\n\r\n \r\n \r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003Cdiv class=\u0022rr-separator\u0022 class=\u0022clearfix\u0022\u003E\r\n\r\n \u003Cdiv class=\u0022light-grey-line\u0022\u003E\u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n \u003C\/div\u003E\r\n\r\n\u003C\/div\u003E\r\n \u003C\/div\u003E\n \u003C\/div\u003E\n \n \u003Ch2 class=\u0022element-invisible\u0022\u003EPages\u003C\/h2\u003E\u003Cul class=\u0022pager\u0022\u003E\u003Cli class=\u0022pager-current first\u0022\u003E1\u003C\/li\u003E\n\u003Cli class=\u0022pager-item\u0022\u003E\u003Ca title=\u0022Go to page 2\u0022 href=\u0022\/content\/364\/bmj.l1481?sort_by=field_highwire_a_epubdate_value\u0026amp;sort_order=DESC\u0026amp;items_per_page=10\u0026amp;page=1\u0022\u003E2\u003C\/a\u003E\u003C\/li\u003E\n\u003Cli class=\u0022pager-item\u0022\u003E\u003Ca title=\u0022Go to page 3\u0022 href=\u0022\/content\/364\/bmj.l1481?sort_by=field_highwire_a_epubdate_value\u0026amp;sort_order=DESC\u0026amp;items_per_page=10\u0026amp;page=2\u0022\u003E3\u003C\/a\u003E\u003C\/li\u003E\n\u003Cli class=\u0022pager-next\u0022\u003E\u003Ca title=\u0022Go to next page\u0022 href=\u0022\/content\/364\/bmj.l1481?sort_by=field_highwire_a_epubdate_value\u0026amp;sort_order=DESC\u0026amp;items_per_page=10\u0026amp;page=1\u0022\u003Enext \u203a\u003C\/a\u003E\u003C\/li\u003E\n\u003Cli class=\u0022pager-last last\u0022\u003E\u003Ca title=\u0022Go to last page\u0022 href=\u0022\/content\/364\/bmj.l1481?sort_by=field_highwire_a_epubdate_value\u0026amp;sort_order=DESC\u0026amp;items_per_page=10\u0026amp;page=2\u0022\u003Elast \u00bb\u003C\/a\u003E\u003C\/li\u003E\n\u003C\/ul\u003E \n \n \n \n \n\u003C\/div\u003E \u003C\/div\u003E\n\n \n \u003C\/div\u003E\n\u003C\/div\u003E\n \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003C\/body\u003E\u003C\/html\u003E"}